European Journal of Pediatrics最新文献

{"title":"Surgical risk stratification and outcome analysis of Tenckhoff catheter implantations in paediatric patients: a single-centre experience.","authors":"Michail Aftzoglou, Katerina Dadouli, Gwendolyn Eich, Konrad Reinshagen, Christian Tomuschat","doi":"10.1007/s00431-025-06006-x","DOIUrl":"10.1007/s00431-025-06006-x","url":null,"abstract":"<p><p>This study aimed to assess the risk factors for complications post-Tenckhoff catheter implantation in paediatric patients. All records of children who underwent the procedure from 2002 to 2022 at the University Medical Centre of Hamburg were analyzed. The demographic and anthropometric characteristics were scrutinized, with particular attention given to complications such as catheter leakage, occlusions, and peritonitis. Univariate and multivariate analyses were employed to determine the hazard ratios for complications. In total, 299 implantations were performed in 116 females and 130 males; 67% were under 5 years old, and 85% had renal disease. Fifty-one percent needed an acute catheter insertion, 26% of the patient's required revision, and 24% of the patients experienced peritonitis. Neonates had a 22% mortality rate, and infants had a 37% reimplantation rate. Compared with the other subgroups, a glomerular filtration rate of 15-29 ml/kg/1.7 3m² was associated with a 10.7-fold higher risk of peritonitis. Male patients had a threefold greater chance of reimplantation or inguinal hernia. Omentectomy revealed no increased risk of peritonitis, and only two catheter occlusions were observed. Patients with inguinal hernias or gastric tubes had higher odds of complications (HR = 3.60, p = 0.003 and OR = 2.47, p = 0.014). Neither the implantation side nor acute insertion was correlated with complications.</p><p><strong>Conclusion: </strong>Infants, male patients with kidney disease, prolonged use of catheter, and those with a GFR of 15-29 ml/kg/1.73 m² were at increased risk. The presence of peritonitis, inguinal hernia, and gastric tubes were adverse prognostic factors.</p><p><strong>What is known: </strong>• Omentectomy can serve as a protective factor and correlates with a lower incidence of catheter malfunction. • The insertion of gastric tubes is commonly associated with complications but has lower risk of complications if inserted prior to the initiation of peritoneal dialysis.</p><p><strong>What is new: </strong>• Males have been found to have a 2.14 hazard ratio for revision in both acute and chronic peritoneal dialysis groups. • The incidence of revisions seems to be greater in the first 36 months, while the incidence of peritonitis rises by 7% for each additional year of age.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"172"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor difficulties in children with neurodevelopmental conditions: a report from a cross-national study in Belgian and Italian children.","authors":"Evi Verbecque, Charlotte Johnson, Gaia Scaccabarozzi, Massimo Molteni, Katrijn Klingels, Alessandro Crippa","doi":"10.1007/s00431-025-06009-8","DOIUrl":"https://doi.org/10.1007/s00431-025-06009-8","url":null,"abstract":"<p><p>Motor behavior alterations are common in neurodevelopmental disorders (NDDs), including autism, developmental coordination disorder (DCD), and attention deficit hyperactivity disorder (ADHD), but the extent of motor impairment remains unclear. In autism and ADHD, motor difficulties may be linked to co-occurring DCD, which often goes unrecognized. We aimed to map the prevalence of DCD in autism and ADHD, and to explore motor skill difficulties using the Movement Assessment Battery for Children-2 (MABC-2), by comparing children with typical motor development (TMD) with those who have NDDs, and by identifying specific profiles among NDDs. A combined sample of participants (n = 215), including autistic children with(out) intellectual disability (ID) and children with ADHD, DCD, and TMD, performed the MABC-2. Depending on co-occurring DCD/ID, subgroups were composed: autism-only (n = 17), autism + ID (n = 17), autism + DCD (n = 40), ADHD-only (n = 14), ADHD + DCD (n = 12), DCD (n = 25), and TMD (n = 59). MABC-2 differences between TMD/NDDs (Mann-Whitney U test) and among NDDs (Kruskal-Wallis test) were assessed. DCD occurred in 70.2% of the autistic children without ID and in 46.2% of those with ADHD. Children with NDDs performed significantly worse than the TMD (p < 0.001). Manual dexterity skills, aiming and catching, and balance were significantly different across the NDD subgroups (p ≤ 0.001). Particularly children with ( +)DCD and autism + ID performed worse on manual dexterity skills. Children with ( +)DCD were outperformed on aiming and catching. All subgroups, except the ADHD-only group, performed poorly on balance.</p><p><strong>Conclusion: </strong>Distinct motor difficulties were identified across various NDDs. Children with co-occurring ID or DCD exhibit unique challenges, stressing the importance of motor profile subgrouping.</p><p><strong>What is known: </strong>• Despite the common occurrence of motor behavior in neurodevelopmental disorders, the extent of motor impairment remains unclear. • Motor difficulties in autism and ADHD may be linked to co-occurring DCD, which often goes unrecognized.</p><p><strong>What is new: </strong>• DCD occurred in 70% of the autistic children without ID and in 46% of those with ADHD. • Children with co-occurring ID or DCD exhibit unique challenges, stressing the importance of motor profile subgrouping.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"174"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycythemia vera and essential thrombocythemia in children, still a challenge for pediatricians.","authors":"Agathe Picard, Sophie Bayart, Marianna Deparis, Cécile Dumesnil De Maricourt, Sophie Haro, Anne Jourdain, Coralie Mallebranche, Fanny Rialland, Damien Luque Paz, Cedric Pastoret, Virginie Gandemer, Elie Cousin","doi":"10.1007/s00431-025-05993-1","DOIUrl":"10.1007/s00431-025-05993-1","url":null,"abstract":"<p><p>Polycythemia vera (PV) and essential thrombocythemia (ET) are rare myeloproliferative neoplasms (MPN) in children, adolescents and young adults. No recommendations are available concerning these patients' management. Transposing to children the knowledge established in adult patients is not acceptable. For a better understanding of difficulties encountered by pediatricians and adult hematologists, we conducted a national practice analysis concerning follow-up of patients under 18 diagnosed with ET or PV, in France. Then, we present data from a multicentric, descriptive, retrospective study, including 17 patients with ET or PV, diagnosed under 18, coming from 7 hematopediatric departments in France. Interviewed physicians reported a lack of expertise and theoretical training in the hematological field to diagnose and follow children with MPNs. Data from 17 patients (15 ET, 2 PV) confirmed a high proportion of asymptomatic patients at the time of diagnosis (41%). Proportion of \"triple-negative\" patients (59%) was higher than in adult cohorts. 60% of patients underwent a bone marrow biopsy and 31% of cases were discussed during a multi-disciplinary staff meeting. 76.5% patients were treated, with a high frequency of antithrombotic and cytoreductive drugs. No complications were observed during the 45 months of median follow-up.</p><p><strong>Conclusion: </strong>Physicians insisted on the need for training. Only the accumulation of descriptions of MPNs in children will lead to a better management of these diseases. Considering the small proportion of pediatric patients with complications after diagnosis, rapid therapeutic de-escalation seems essential to consider during the follow-up in a close collaboration with adult hematologists.</p><p><strong>What is known: </strong>• Myeloproliferativ neoplams are rare and chronic deseases, most of the time affecting adults but also found in few pediatric patients. • There are no recommendations for the diagnosis, therapeutic management or follow-up of children with polycythemia vera or essential thrombocythemia.</p><p><strong>What is new: </strong>• Find out how adult haematologists and paediatricians feel about the management and follow-up of paediatric patients with myeloproliferative syndrome through a national practice analysis. • Description of the \"real life\" follow-up of children with polycythemia vera or essential thrombocythemia in France.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"173"},"PeriodicalIF":3.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11794414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric head and neck sarcomas: a retrospective study from a national tertiary referral center.","authors":"Eiman Abu Bandora, Liyona Kampel, Michal Manisterski, Ronit Elhasid, Dror Levin, Gilad Horowitz, Anton Warshavsky, Raphael Wolf, Ari DeRowe, Nidal Muhanna","doi":"10.1007/s00431-025-05991-3","DOIUrl":"https://doi.org/10.1007/s00431-025-05991-3","url":null,"abstract":"<p><p>This study aims to analyze the demographics, therapeutic approaches, and outcomes of pediatric sarcomas of the head and neck treated at a single tertiary referral center. We retrospectively reviewed the medical charts of all pediatric patients diagnosed with head and neck sarcomas treated at the Tel Aviv Sourasky Medical Center during 2002-2021. Clinical data, oncologic and surgical treatments, and outcome measures were retrieved from electronic medical files. A total of 52 patients met the inclusion criteria. The mean age at diagnosis was 7.25 ± 6.04 years (range 2 months to 20 years), and the male-to-female ratio was 1.4: 1. The leading histological subtypes were rhabdomyosarcoma (RMS) (50%) followed by Ewing sarcoma (23%). The vast majority (96%) of patients were treated with multimodal therapy that included chemotherapy, surgical resection, and/or radiation therapy. Twenty-nine (55.8%) patients underwent surgical resection. The average follow-up was 4.75 years (range 5 months to 13.5 years). The 1-, 5-, and 10-year overall survival rates were 89.5%, 81.3%, and 62.5%, respectively. Male sex, Ewing sarcoma, and non-metastatic disease at diagnosis were associated with better disease-free survival (DFS) (p = 0.008, p = 0.048, and p = 0.038, respectively). Patients with sarcomas suitable for surgical resection and those who received adjuvant therapy had significantly better DFS (p = 0.003 and p = 0.025, respectively).</p><p><strong>Conclusions: </strong>Head and neck sarcomas in the pediatric population are best managed by a multidisciplinary team. Surgical resection and the integration of adjuvant therapy in selected patients confer survival benefit.</p><p><strong>What is known: </strong>• Head and neck sarcomas pose a considerable challenge to physicians due to their rarity, their heterogenic presentation, and their proximity to vital structures.</p><p><strong>What is new: </strong>• A multimodal therapeutic approach that includes chemotherapy, radiotherapy, and surgical resection when feasible should be provided to these patients in order to optimize survival outcomes. Surgical resection and the integration of adjuvant therapy in selected patients confer survival benefit.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"169"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nirsevimab effectiveness on paediatric emergency visits for RSV bronchiolitis: a test-negative design study.","authors":"Lea Lenglart, Corinne Levy, Romain Basmaci, Karine Levieux, Rolf Kramer, Karine Mari, Stéphane Béchet, Elise Launay, Laure Cohen, Camille Aupiais, Loic de Pontual, Alexis Rybak, Yannis Lassoued, Naim Ouldali, Robert Cohen","doi":"10.1007/s00431-025-06008-9","DOIUrl":"https://doi.org/10.1007/s00431-025-06008-9","url":null,"abstract":"<p><p>Bronchiolitis is one of the leading reasons for paediatric emergency department (PED) visits. France was one of the few countries in the world to implement nirsevimab during winter 2023-2024 in order to reduce the burden of bronchiolitis each year. We conducted a test-negative design study, including all infants younger than 1, diagnosed with a first episode of bronchiolitis. We included all cases presenting to the PED of five university hospitals across France, between October 1, 2023, and February 29, 2024, and undergoing a nasopharyngeal sample for RSV testing. Case patients were the RSV-positive bronchiolitis and control patients the RSV-negative. As a follow-up, all parents were contacted by e-mail 15 days after inclusion. We included 383 bronchiolitis patients, of which 274 tested positive for RSV (75.2%). Among case patients, 27/274 (9.8%) received nirsevimab, compared to 50/109 (46.2%) among control patients. Nirsevimab had an adjusted estimated effectiveness of 82.5% (95% CI [68.0-90.8]) at PEDs. Sensitivity analyses found similar results. At 15-day follow-up, characteristics were similar between children immunized by nirsevimab or not.</p><p><strong>Conclusion: </strong>Our findings advocate for nirsevimab widespread adoption to alleviate the burden of RSV bronchiolitis in paediatric emergency departments.</p><p><strong>Trial registration: </strong>NCT04743609 (date of registration: February 4, 2021).</p><p><strong>What is known: </strong>• Each year, RSV-bronchiolitis places significant pressure on pediatric emergency services. • France is one of the first countries in the world to have implemented nirsevimab in septembre 2023.</p><p><strong>What is new: </strong>• Nirsevimab effectiveness on pediatric emergency visits for RSV-bronchiolitis has been estimated to 82.5% (95% CI [68.0-90.8]) in our study. • The effectiveness was as strong to prevent hospitalizations and sever illnesses.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"171"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of and factors associated with hypophosphatemia in children and adolescents receiving cancer treatment: a single-center, retrospective study.","authors":"Aoi Ogawa, Kenji Kishimoto, Shogo Horikawa, Suguru Uemura, Sayaka Hyodo, Aiko Kozaki, Atsuro Saito, Toshiaki Ishida, Takeshi Mori, Daiichiro Hasegawa, Yoshiyuki Kosaka","doi":"10.1007/s00431-025-06002-1","DOIUrl":"https://doi.org/10.1007/s00431-025-06002-1","url":null,"abstract":"<p><p>The aim of this study was to determine the incidence of hypophosphatemia and identify factors associated with high-risk hypophosphatemia in children and adolescents with cancer. Patients aged 0-18 years who developed hypophosphatemia during treatment for cancer in our hospital between January 2021 and March 2023 were enrolled. Hypophosphatemia was defined as a serum phosphorus level < 2.5 mg/dL. The high-risk group for symptomatic hypophosphatemia was defined as patients with a serum phosphorus level of 1.5-1.9 mg/dL lasting for 2 weeks or more and patients with a serum phosphorus level < 1.5 mg/dL. During the study period, 48 of 253 (19%) patients developed a total of 108 episodes of hypophosphatemia. Symptomatic episodes were more frequent in the high-risk group (n = 31; 84% vs. 39%). Elevated total bilirubin level (> 0.50 mg/dL) (adjusted odds ratio (OR), 3.60; 95% confidence interval (CI), 1.37-9.48) and stem cell transplantation (adjusted OR, 4.83; 95% CI, 1.69-13.81) were found to be potential baseline predictors of high-risk hypophosphatemia in the logistic regression model. Fasting, diarrhea, and vomiting after initiation of treatment were also associated with the development of high-risk hypophosphatemia.</p><p><strong>Conclusions: </strong>The incidence of hypophosphatemia was relatively high in children and adolescents receiving treatment for cancer. The results suggest that baseline characteristics and therapy-related toxicities may be associated with the development of high-risk hypophosphatemia.</p><p><strong>What is known: </strong>• Patients with cancer are at increased risk of hypophosphatemia in adults. • Hypophosphatemia may be a factor associated with a poor prognosis in hospitalized patients.</p><p><strong>What is new: </strong>• The incidence of hypophosphatemia was relatively high in children and adolescents receiving treatment for cancer. • Both baseline characteristics and therapy-related factors may be associated with the development of high-risk hypophosphatemia.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"170"},"PeriodicalIF":3.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental functional brain network abnormalities in autism spectrum disorder comorbid with attention deficit hyperactivity disorder.","authors":"Tiantian Wang, Yang Xue, Zakaria Ahmed Mohamed, Feiyong Jia","doi":"10.1007/s00431-025-05989-x","DOIUrl":"https://doi.org/10.1007/s00431-025-05989-x","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Developmental stages significantly influence the variations in brain alterations. However, whether ASD comorbid with ADHD (ASD + ADHD) represents a unique neural characteristic from ASD without comorbid ADHD (ASD-alone), or instead manifests a shared neural correlate associated with ASD across diverse age cohorts remain unclear. This study examined topological properties and functional connectivity (FC) patterns through resting-state functional magnetic resonance imaging data from the Autism Brain Imaging Data Exchange II. Participants were divided into two age cohorts: childhood (under 12 years) and adolescence (12-18 years), consisting of 171 ASD pediatric patients and 111 typically developing (TD) controls. These cohorts were further classified into subgroups of ASD + ADHD, ASD-alone, and TD controls to compare across the age categories. The age, intelligence quotient, and gender of participants across three groups were matched within childhood and adolescence stages. We constructed functional brain networks, conducted graph-theory analysis, and analysed FC for both age cohorts. The findings revealed that both ASD + ADHD and ASD-alone shared some FC dysfunctions in the Default Mode Network (DMN) and atypical global metrics. Additionally, each group demonstrated unique neural FC and topological profiles that evolved with development.</p><p><strong>Conclusions: </strong>This study highlights the neural profiles of ASD + ADHD from a developmental perspective and suggests age-considerate approaches in clinical treatments.</p><p><strong>What is known: </strong>• ASD + ADHD shared some neural correlate associated with ASD-alone and also had specific neurobiological mechanisms which were different from ASD-alone. • Developmental stages significantly influence the variations in brain alterations observed in ASD or ADHD.</p><p><strong>What is new: </strong>• Both ASD + ADHD and ASD-alone shared some FC dysfunctions in the Default Mode Network and atypical global metrics. • ASD + ADHD and ASD-alone demonstrated unique neural FC and topological profiles that evolved with development.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"166"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing bronchiolitis severity: a comparative analysis of two commonly used clinical scoring systems.","authors":"Nikhil Rajvanshi, Jashan Mittal, Prawin Kumar, Jagdish Prasad Goyal","doi":"10.1007/s00431-025-06000-3","DOIUrl":"https://doi.org/10.1007/s00431-025-06000-3","url":null,"abstract":"<p><p>The purpose of this study to compare the effectiveness of the Bronchiolitis Severity Score (BSS) and the Respiratory Distress Assessment Instrument (RDAI) in determining bronchiolitis severity and predicting outcomes. Additionally, it aimed to establish optimum cutoff points for both scores. In this prospective observational study, clinical details of enrolled infants, along with assessments using both scoring tools, were recorded. The performance of these scores in predicting \"severe disease,\" defined by respiratory support requirements other than nasal prongs, PICU admission, respiratory acidosis, and/or altered consciousness, was evaluated. A total of 64 infants diagnosed with bronchiolitis were enrolled with a median age of 5 (3.8) months, and 16 (25%) infants had severe disease. BSS showed 25% sensitivity and 97.9% specificity at established cutoffs of > 8 for severe bronchiolitis. BSS performed better than RDAI in differentiating severe bronchiolitis [AUC, 0.733 vs 0.605; p = 0.035]. New cutoffs of > 5 points for BSS and > 8 points for RDAI increased BSS sensitivity to 68.8% and RDAI sensitivity to 56.3%.</p><p><strong>Conclusion: </strong>BSS demonstrated superior discriminative ability compared to RDAI in identifying severe bronchiolitis. New cutoff points enhanced BSS's ability to classify severe cases while establishing a cutoff for RDAI. Additional studies are required to validate these revised cutoffs.</p><p><strong>What is known: </strong>• Bronchiolitis severity score (BSS) and Respiratory Distress Assessment Instrument (RDAI) helps in determining bronchiolitis severity.</p><p><strong>What is new: </strong>• BSS has superior discriminatory ability as compared to RDAI in determining bronchiolitis severity. • This study also highlights that neither BSS nor RDAI is perfect, emphasizing the importance of clinical judgment over scoring systems.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"167"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"M-mode measurement of diaphragm excursion.","authors":"Yusuke Hoshino","doi":"10.1007/s00431-025-06003-0","DOIUrl":"https://doi.org/10.1007/s00431-025-06003-0","url":null,"abstract":"","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"168"},"PeriodicalIF":3.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of severe hypoglycemia management in children and adolescents with type 1 diabetes in a Belgian tertiary pediatric care center: impact of intranasal glucagon and cost analysis.","authors":"Antoine Harvengt, Anaïs Maure, Maude Beckers, Laure Boutsen, Chloé Brunelle, Elise Costenoble, Philippe Lysy","doi":"10.1007/s00431-025-05992-2","DOIUrl":"https://doi.org/10.1007/s00431-025-05992-2","url":null,"abstract":"<p><p>To evaluate the management and costs of severe hypoglycemia (SH) in children and adolescents with type 1 diabetes (T1D) in our Belgian tertiary pediatric care center. In the EPI-GLUREDIA study, clinical parameters from children and adolescents with T1D were retrospectively analyzed from July 2017 to June 2024. The characteristics of SH and its treatment were collected during the medical consultation following the SH episode. Between July 2017 and June 2024, 208 cases of SH were recorded in 113 children and adolescents with T1D, with an average age of 13.6 years and T1D duration of 6.2 years. Oral glucose was the most common treatment (47.4%), while glucagon was used in only 25.4% of cases and more frequently in boys (30.8%) than in girls (18.7%). Notably, only 43% of SH episodes were treated according to international guidelines. A significant increase in glucagon use was observed after reimbursement of its intranasal form in Belgium in January 2022. After 2022, glucagon use significantly increased (28/81 vs. 25/129; p = 0.013), particularly among teachers and educators (18/49 vs. 10/78; p = 0.002). The average direct cost of treating SH was €187.9, with costs ranging from €0 to €1092.5 depending on the treatment method.Conculusion: Our study underscores the difficulty in managing SH in young people with T1D, with only 43% being treated as per guidelines. Since 2022, the increased use of the intranasal form of glucagon in Belgium led to reduced healthcare costs and improved care of patients experiencing SH.</p>","PeriodicalId":11997,"journal":{"name":"European Journal of Pediatrics","volume":"184 2","pages":"162"},"PeriodicalIF":3.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}